Clinical Nutrition

Question 1

There are four components to the NCP:

nutrition _______

nutrition ________

nutrition _________

nutrition _________________

Answer 1

assessment

diagnosis

intervention

monitoring and evaluation.

Question 2

Nutrition _________ is defined as a “systematic process of obtaining, verifying, and interpreting data in order to make decisions about the nature and cause of nutrition-related problems.”

Answer 2

assessment

Question 3

The “A–E of Nutrition assessment.”

A— _________________ or _____________
B — ____________ analyses
C— __________ usually performed by the physician
D— __________ analysis and assessment to determine usual ______
E— __________ assessment

Answer 3

anthropometric or body composition measurements

biochemical

clinical examination

dietary; food intake

environmental

Question 4

Dietary analysis of a patient is generally performed by the ______

Answer 4

Registered dietitian

Question 5

anthropometric or body composition measurements include:

BMI
_____ circumference
______ thickness,
_______ weighing,
____________(ADP)
______________ (DEXA)
__________________________ (BIA),

Answer 5

Waist

Skinfold

Hydrostatic

Air-displacement plethysmography

Dual energy x-ray absorptiometry

Bioelectrical impedance analysis

Question 6

Biochemical assessment markers are divided into 2- __________ and _______ markers.

Answer 6

macronutrients and micronutrients

Question 7

The macronutrients include markers of ________,_________, and _______ metabolism and utilization.

Answer 7

carbohydrate, protein, and fat

Question 8

Micronutrients measurements are not important.

T/F

Answer 8

F

Micronutrients measurements are also very important.

Question 9

Liver function will be affected if there is insufficient ______ and excess _____.

Answer 9

protein; fats

Question 10

An excessive intake of protein may also be harmful to kidney function

T/F

Answer 10

T

due to the excess of non-protein nitrogen compounds formed that must then be removed.

Question 11

The clinical component of the nutrition assessment

This consists of the _____ (_____,_______, and ________) and ___________

Answer 11

history

present , past and family

physical examination

Question 12

Metabolic syndrome is defined by utilizing information derived from the ________ components (____) of a nutrition assessment

Answer 12

first three ; A–C

Question 13

The parameters include for metabolic syndrome include:

1. An elevated waist circumference. In women,____ inches (____ cm); in men, ____ inches (____ cm)
2. Elevated triglyceride levels > ____ mg/dL (1.7mmoles/L)
3. Elevated fasting glucose > ____ mg/dL (____ mmoles/L)
4. Reduced HDL cholesterol. In women, ____ mg/dL(1.3mmoles/L); in men, ____ mg/dL(1.03mmoles/L)
5. Elevated blood pressure > ___/___ mm Hg

Answer 13

35;88;40;102

150; 110;6.1

50; 40

130/85

Question 14

There are several ways to assess adequacy of intake

__________________ System.

___________________ [RDA]

___________ [AI]

tolerable __________

Answer 14

the USDA Food Guidance

Recommended Dietary Allowance

adequate intake

upper limits

Question 15

Examples of tools used by the registered dietitian to determine dietary adequacy include the ________, the _______ record or diary, and/or the ________ questionnaire.

Answer 15

24-hour recall

3-day food

food frequency

Question 16

The ideal proteins markers have a (short or long?) biologic half-life

Answer 16

Short

Question 17

Serum albumin half-life??

Serum pre-albumin half life??

Answer 17

20 days

2 days

Question 18

Serum albumin is a good indicator of short-term protein and energy deprivation

T/F

Answer 18

F

Serum albumin is not a good indicator of short-term protein and energy deprivation

Question 19

Serum albumin is a good indicator of chronic deficiency.

T/F

Answer 19

T

Question 20

Albumin’s function as a biochemical marker

1) to identify chronic protein deficiency under conditions of ________________(eg _______)

2) presence of ________ in which metabolic adaptations keeps ________________( eg __________)

Answer 20

adequate non–-protein-calorie intake; kwashiorkor

caloric insufficiency; protein levels within reference range.

marasmus

Question 21

Serum albumin levels of ___/L are considered normal.

Albumin levels of _____ to ___ g/L indicate mild malnutrition

Levels of _____ to _____ g/L indicate moderate malnutrition Levels

less than ______ g/L indicate severe malnutrition.

Answer 21

35 g

28–30 ; 35

23–25 ; 28–30

23–25

Question 22

Half-life

Transferrin

Albumin

Prealbumin

RBP

Answer 22

9 days

20days

2days

12hours

Question 23

Transferrin
It is synthesized in the _____ and binds and transports ____ iron.

Answer 23

liver; ferric

Question 24

Transferrin synthesis is regulated by ________.

When hepatocyte iron is absent or low, transferrin levels (rise or drops?) in proportion to the deficiency.

Answer 24

iron stores

rise

Question 25

the (elevated or depressed?) transferrin is the (first or last?) analyte to return to normal when iron deficiency is corrected.

Answer 25

Elevated Last

Question 26

Which is most likely to indicate protein depletion first between transferrin, prealbumin and albumin?

Answer 26

Prealbumin Transferrin Albumin

Question 27

________ and _______ are considered the major transport proteins for thyroxine and vitamin A,

Answer 27

Transthyretin and RBP

Question 28

Concentrations of transthyretin appear to be significantly influenced by fluctuations in the hydration state, liver disease or renal disease. T/F

Answer 28

F Concentrations of transthyretin do not appear to be significantly influenced by fluctuations in the hydration state, liver disease or renal disease.

Question 29

RBP interacts strongly with plasma _______ and circulates in the plasma as a __:___ mol/L ________-________ complex.

Answer 29

transthyretin 1:1 transthyretin–RBP

Question 30

A potential problem exists in using RBP as a nutritional marker, however. Although RBP has a shorter half-life than transthyretin (_____, compared with __________), it is _______, and its concentration _____eases more significantly than transthyretin in patients with renal failure.

Answer 30

12 hours 2 days excreted in urine incr

Question 31

The molecular size and structure of IGF-1 is similar to proinsulin. T/F

Answer 31

T

Question 32

In the healthy adult population, anabolic and catabolic rates are _________, and the nitrogen balance approaches _____.

Answer 32

in equilibrium zero

Question 33

Therefore, the determination of ________________ is a method for estimating the amount of nitrogen excretion.

Answer 33

24-hour urinary urea nitrogen (UUN)

Question 34

Nitrogen balance, as calculated by this equation, is not valid in patients with severe ______ or ______ or in patients with __________

Answer 34

stress or sepsis renal disease

Question 35

The two common PEM states are ________ and ________

Answer 35

Marasmus and Kwashiorkor

Question 36

Marasmus : ______ undernutrition affecting __________ especially insufficiency of ________________________

Answer 36

Generalized all food nutrients both protein and CHO.

Question 37

non-oedematous PEM = _________

Answer 37

Marasmus

Question 38

In marasmus ______________ causes serum protein and electrolytes to remain within reference range hence no oedema

Answer 38

Starvation adaptation

Question 39

In marasmus, Presence or absence of edema

Answer 39

Absence

Question 40

Absence of oedema with muscle wasting is characteristic of __________

Answer 40

marasmus

Question 41

Kwashiorkor is a condition caused by severe _______ in individuals with _____ energy intake.

Answer 41

protein deficiency adequate

Question 42

Kwashiorkor Characterised by anorexia, severe _____ with hypoproteinaemia, _______ hair and skin, ________ abdomen due to ______.

Answer 42

odema; depigmented distended; fatty liver

Question 43

Kwashiorkor is A disease of weaning. T/F

Answer 43

T

Question 44

Biochemistry of Kwashiorkor (Low or high?) protein to energy ratio causes -(low or high?) insulin -(low or high?) cortisol -increased uptake of amino acid into _____, diverting them from the _____

Answer 44

Low High Low muscle; liver

Question 45

Biochemistry of Kwashiorkor - ____eased albumin synthesis -____eased plasma oncortic pressure leading to _____ -Insulin promotes lipo_____ leading to the storage of ____ in hepatocytes causing ________.

Answer 45

Decr Decr; odema genesis; LDL; fatty liver

Question 46

Parenteral nutritional preparations are usually administered through a _________.

Answer 46

subclavian catheter

Question 47

TPN administration bypasses normal absorption and circulation routes T/F

Answer 47

T